| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $441.80 | $441.80 | $441.80 | |
Aetna
| Professional | $15.74 | $324.30 | $441.80 | |
Cigna
| Facility | $318.39 | $318.39 | $318.39 | |
Cigna
| Professional | $270.64 | $270.64 | $592.28 | |
Medica
| Facility | $51.63 | $265.14 | $441.80 | |
Medica
| Professional | $15.45 | $24.24 | $87.77 | |
United
| Professional | $16.16 | $24.24 | $278.76 |